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AHRQ Announces Studies Comparing Effectiveness of Treatments in Medicare

The Agency for Healthcare Research and Quality announced plans Wednesday for studies it said will help point Medicare policymakers, beneficiaries, and doctors to the most effective types of treatments in 10 areas.

By reviewing both published and unpublished scientific literature, the study "will provide invaluable information to providers and patients who need to make evidence-based decisions about treatments and interventions every day," said Dr. Carolyn Clancy, the AHRQ administrator.

AHRQ's history includes a move in Congress in the mid-1990s to zero out funding of the agency after it issued guidelines on effective treatment of low back pain that infuriated spine surgeons.

Many observers since then have expressed doubt that the federal government would be willing to fund a major research program that might lead to winners and losers in markets for health care products and treatments.

Nevertheless, the studies announced Wednesday wade into treatment areas that involve heavy health care spending. The areas reflect research priorities picked not only by representatives of AHRQ but also of the Food and Drug Administration, the HHS Office of the Secretary, and the Centers for Medicare and Medicaid Services.

Further insulating AHRQ from the potential fallout is the fact that it is no longer issuing treatment guidelines on the most effective treatments. Rather, it is funding "Evidence-Based Practice Centers" in largely academic settings to prepare the literature reviews.

"They're not guidelines, they're evidence reviews," an AHRQ spokeswoman said of the coming reports.

Among the studies announced are those that will address strategies to manage gastroesophageal reflux disease; benefits and safety of analgesics for osteoarthritis; new technologies for diagnosing breast cancer; the use of Epoetin and Darbepoetin for managing anemia in patients receiving cancer treatment; and off-label use of atypical anti-psychotic medications.

Other announced studies will focus on renal artery stenting compared to aggressive anti-hypertensive therapy for mild renal artery stenosis; treatments for localized prostate cancer; depression drugs; oral drugs for diabetes; and drugs and "behavioral interventions" such as diet, exercise, and vitamin supplements for osteoporosis and osteopenia.

The research program is funded under Section 1013 of the Medicare overhaul law (PL 108-173), championed by Senate Majority Leader Bill Frist, R-Tenn.

"This AHRQ research is another modest step in the Republican revolution in health care—where Uncle Sam wants proven value for each Medicare dollar," said Alec Vachon, a former GOP staffer on the Senate Finance Committee who now works as a consultant. "CMS head Mark McClellan and Majority Leader Bill Frist may look button-down, but don't be fooled—on this issue, they are wild-eyed radicals."

AHRQ said it will announce research reviews in the future relating to Medicaid and the State Children's Health Insurance Program. Findings of the reviews for all three programs are available generally to the public, including doctors, patients, and health plans in the commercial marketplace.

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